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Otitis Media

Otitis media is the most commonly diagnosed illness in childhood. This infection occurs in half of all infants before their first birthday and in 80% by their third birthday. Half of all infected children will have 3 or more episodes in their first 3 years of ear infection, ear ache, otitis media, otitis medea

Pathophysiology

Otitis media is classified as either acute otitis media or otitis media with effusion.

Acute otitis media consists of inflammation of the middle ear, presenting with a rapid onset of symptoms and clinical signs of ear pathology. Fever and ear pain are the most common acute

Otitis media with effusion consists of a chronic bacterial infection persisting more than 2 weeks, manifesting as an asymptomatic middle-ear effusion. The syndrome usually develops after an acute otitis media.

Treatment of acute otitis media

First-line antibiotics

Oral antibiotics should be prescribed for 

Amoxicillin is the first-line antimicrobial agent for treating AOM, at doses of 80-90 mg/kg/d. For patients with treatment failure after three days of therapy, alternative agents include

Streptococcus pneumoniae causes 40-50% of all cases of AOM. This agent has reduced susceptibility to penicillin in 8-35% (2-4% highly resistant) of isolates and reduced susceptibility to

Cefuroxime axetil (Ceftin) and amoxicillin-clavulanate (Augmentin) orally, and ceftriaxone (Rocephin) intramuscularly, are useful as second-line drugs for treatment failure, which is defined as 

Trimethoprim-sulfamethoxazole, erythromycin-sulfisoxazole, clarithromycin and azithromycin are ineffective for